Today's announcement of a huge expansion of personal budgets in social care, so that everyone eligible for a personal budget has access to one by 2013, is really welcome news. Progress in the roll out of personal budgets has been frustratingly slow – between 2007 and spring this year, only 13% of care users had one. And this hides huge local variation, with some councils only offering them in a handful of cases, and usually to young disabled people. Older people and those with mental health conditions have been left behind. But now we have renewed momentum: the fast approaching April 2011 target of 30% of care users having a personal budget, last week's personalisation strategy, and now the new 100% 2013 target, which is bound to focus councils minds.

But we should bear in mind that this new big push is coinciding with unprecedented budgetary cuts. By the time everyone is supposed to have a personal budget in 2013, councils will have had to cut their spending by 20%.

And there is a risk that personal budgets will be used as a tool in making those cuts. Picture this: an older person receiving 20 hours a week home care is offered a personal budget. Their needs are assessed, and they are given £180 per week in a personal budget by the council. In their area, however, home care costs £10 per hour, meaning this older person may now only be able to afford 18 hours care a week. Now of course, we can argue that the older person in question didn't want to spend their personal budget on home care anyway; they prefer going out to the cinema and can do without all those hours of help. Indeed, this is the point of a personal budget: people can spend it on the lower level, often cheaper services that they prefer. But if councils assume this will always be the case, we risk systematically undercutting the actual price of care services, creating disruption for those care users who have relied on the same level and type of care for years and have no desire to change.

Recent research by Demos has found people who pay for social care themselves often have their choices limited by a lack of resources, suggesting there may be an affordability problem in care services at local level. Care users newly armed with personal budgets may run into the same problem and councils risk compounding this if the amount they allocate in personal budgets is wholly determined by what they think they can afford, and not the reality of the local market for care services.

Personal budgets can and do often lead to more cost effective care. The temptation to assume this will always be the case and systematically reduce personal budget allocations to save cash must be powerful. But councils must see the true value of personal budgets is in giving people control over their own lives, not in getting more for less. If personal budget holders are priced out of the care service market, this national policy is set for a spectacular backfire on the ground.

New Comment